The Peace of Mind Prescription: An Authoritative Guide to Finding the Most Effective Treatment for Anxiety and Depression by Charles Nemeroff, Dennis Charney, Stephen Braun (Editor)

From the Publisher

Anxiety and depression rank among the most serious medical disorders today. According to the World Health Organization, depression causes more disabilities than any other condition. Yet 80 percent of the 38 million Americans suffering from anxiety and depression receive inadequate treatment.
Inspired by their work with patients and patient-advocacy groups, the psychiatrists Dennis S. Charney and Charles B. Nemeroff are on a mission to help everyone get the best treatment available. Stressing that any treatment must be tailored to the individual, The Peace of Mind Prescription details the full array of medically approved drugs and therapies, highlights the latest breakthroughs, and explores future possibilities. It advocates treating most adults with a combination of psychotherapy and medication and confirms the link between serious anxiety and depression and physical diseases. The authors examine the controversial question of treating children with medication, and they provide vital information specific to both sexes and all ages.
The Peace of Mind Prescription arms readers with resources to assess claims made for both mainstream and alternative treatments. It features inspiring stories of patients who have overcome their anxiety and depression disorders. Fresh, authoritative, and empowering, this book is a prescription that can aid everyone in need.

Product Details

• Table of Contents
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Table of Contents

Read an Excerpt

Introduction Empowering People with Anxiety and Depression

Anxiety and depression are two of the most serious medical disorders. The suffering caused by these conditions is not only miserable, grinding, and so intolerable that suicide can appear a welcome relief, but it is diabolically long- lasting if not treated. We used to view anxiety and depression as afflictions of middle age. We now know that they strike the young with equal force and can be ruinous throughout life unless treated. We used to think that anxiety and depression were purely mental ills— disorders of emotion, thinking, and perspective. In fact, anxiety and depression are deeply rooted in the body, and their corrosive effects raise a person’s risk of contracting a host of diseases, including heart disease, stroke, diabetes, and osteoporosis.
Depression alone is the leading cause of disability in the United States and the rest of the world. It costs employers an estimated $44 billion a year in lost productivity, according to a 2003 article in the Journal of the American Medical Association. Tragically, not only is the true magnitude of the damage wrought by these diseases widely unknown, but millions of people do not recognize their own anxiety or depression, or if they do, they suppress this recognition because of the stigma that stubbornly clings to psychological conditions of all kinds.
This book is our attempt to fight that stigma, raise awareness about the true nature of anxiety and depression, help people find optimal treatment, and empower them so they can better navigate often complicated health-care systems.
We live in remarkably stressful times, filled with informationoverload, demands to perform at high speed, and pressure to multitask. The terrorism and war that have touched all of us in recent years have also added uncertainty and tension to our lives. Unfortunately, humans are not built for this kind of stress. Our brains, our moods, and our emotional responses evolved over millions of years to deal with the challenges of a hunter-gatherer lifestyle, in which new information came at a trickle and the pace of life was, literally, at a walk. The contrast with the demands of the twenty-first century is so stark that the steady rise in anxiety and depression is not surprising. Between 1987 and 1997, for example, the percentage of Americans diagnosed and treated for depression more than tripled. Anxiety and depression are now the two most common mental disorders, affecting 38 million people in the United States alone.
We urgently want to address these dire statistics by improving care for those who are anxious, depressed, or both. Until now no comprehensive and authoritative guide has existed for people seeking the optimal treatment they deserve. In part, that’s because until recently experts have considered anxiety and depression separate maladies. We now know this is false: people often experience symptoms of both, and proper diagnosis and treatment require an appreciation for the interrelatedness of these two disorders.
This book offers the most up-to-date and high-quality information available anywhere about the science and treatment of anxiety and depression. Our recommendations, suggestions, and guidance are grounded in evidence-based medicine, which simply means that we back up our assertions with findings from recent well-designed studies published in peer- reviewed professional journals. We have been fortunate to be involved with dozens of such studies, thousands of patients, and key national patient- advocacy groups. One of us, Dennis S. Charney, oversees scores of research projects every year as chief of Mood and Anxiety Disorder Research at the National Institute of Mental Health. The other, Charles B. Nemeroff, is a professor and chair of the Department of Psychiatry and Behavioral Sciences at Emory University, a leading center for research, training, and clinical care of patients with mood and anxiety disorders. He has treated many of the patients whose stories appear in this book. Because of our prominence in the field, we often consult with leading companies involved in treating anxiety and depression. In the spirit of full disclosure, we list these relationships in the endnotes. Such arrangements, very common in psychiatry, are mutually beneficial and do not compromise our commitment to writing a book based solely on the state of the science and weight of the latest medical evidence.
Our understanding of anxiety and depression is not just a matter of long clinical experience and formal academic training, however. We are not removed from the conditions about which we write. We have our own human foibles and have experienced our share of grief, trageedy, and pain. We would never pretend to know exactly how anybody else feels, but we do have a profound empathy and compassion for everrrrryone who struggles with anxiety and depression—an empathy rooted in our own struggles with life’s slings and arrows.
Our fundamental message is hopeful: people can overcome anxiety and depression and find well-being, zest, and greater emotional resilience. Everyone can make progress. Everyone can get better. Everyone can be happier and healthier. We’re not saying the path will be easy, quick, or painless, but we are certain that good information is the foundation for any successful treatment—and that is what this book contains.
In tackling anxiety or depression, recognize a fact sometimes overlooked by physicians and the medical establishment in general: nobody knows more about you than you do, and you may understand yourself better than you realize. That doesn’t mean you are all-knowing or have plumbed the depths of your own multilayered consciousness. It simply means that you are the ultimate judge of when you need help, when you feel well, and when you think a change is needed in your treatment plan. Like most people, you are wiser and stronger than you may think you are. In the grip of depression or anxiety, you may minimize or dismiss your ability to change, heal, and grow, and this self-doubt is in fact part of the insidious nature of these illnesses.
Though we cannot hear your story directly or tailor what we have to offer to your particular circumstances, we acknowledge the primacy of your own unique life and all of the strengths and weaknesses you bring to bear on dealing with challenges to your health and well-being. There is no magic formula, no “absolutely effective” therapy, no “best” medication that works for everyone. You must weigh the ideas, suggestions, and options presented in this book against your own life, your own values, your own situation, and then act.

Not Just Treatment, but Optimal Treatment

Sadly, millions of people with anxiety and depression are not achieving the relief they deserve. Only about one in five of those with major depression gets adequate treatment, according to a 2003 study. “Adequate” was defined as at least eight half-hour sessions of counseling with a mental health professional or four visits with any type of physician for prescription and management of an antidepressant drug, used for at least thirty days.
Many people simply don’t realize they are sadder, more tired, or more anxious than they need to be. Others know they suffer but don’t seek treatment out of fear, embarrassment, or shame. Such concerns persist despite decades of testimony by people from all walks of life that anxiety and depression are medical conditions just like any other. Nobody is embarrassed to admit they have high blood pressure or diabetes, and nobody should be embarrassed to admit they are dealing with anxiety or depression. Almost all medical diseases involve complicated interacti